How could she not know you have to brush your teeth every day? How do they not know that treatment costs money and insurance isn’t going to cover it all?

These are questions you might find yourself asking. If so, you may be unhappy. In my opinion there’s a spectrum of happiness and expectations:

The right side of the chart is high expectations. The left side is low expectations. The threshold is the level at which your expectations have changed–That is either your low expectations were exceeded or your high expectations were not met.

Looking at the chart you can see that with low expectations, the orange portion, the majority of the chart is happiness with a small sliver of unhappiness if your low expectations were not met or just barely met. The blue portion, the high expectations, of the chart is the opposite. Most of it is unhappiness with a small sliver of happiness if your high expectations were met or just slightly less than met.

How does this translate to practical information?

Patients have low expectations of the dentist. Therefore doing something even slightly better than nothing will make them happy. They expect to wait a long time, pay a lot of money, be in pain or uncomfortable, and be met with indifference by their doctor. Pick one or more of these things and do them better and they’ll be pushed into the happy zone.

You have high expectations of your patients. You expect them to have knowledge of oral medicine (which most don’t), you expect them to understand medical terms (which most don’t), you expect them to value your services (which most don’t), you expect them to take care of the work they pay for (which they don’t). Many don’t know teeth have roots or that there’s bone under their gums.

How does this get resolved? Lower your expectations! The only reasonable expectations you should have of your patients are: expectation to pay for services rendered, and expectation to value your time. If your patients don’t meet those two criteria then that’s unacceptable.

When your expectations of your patients are lower it benefits you by increasing your happiness level but it also benefits them. Since you don’t expect them to know anything you might explain things to them more. Patients will begin to understand things like brushing is important and you have to floss under a bridge. It’s amazing how many people will say “no one ever told me that” about the simplest things like brushing or flossing.

Since this is half my business blog and half my personal blog, I decided to write up a little bit about what’s been occupying my time lately. I’m making a bronze figurine of a while inspired by those like Walter Bosse.

Here’s the drawing that I started with (I’m not great at drawing):

In order to make the bend, I had the brilliant idea of boiling the wax until it was soft and then bending it. This resulted in the whale being cracked into three pieces. I then patched him together with some different colored wax, hence the strange colors. It won’t show in the final casting. Here’s the almost finished product:

I still have to carve two more “wave” pieces to finish it off and then polish it up, etc. Here’s one of the wave carvings halfway through:

A big objection to pursuing a new strategy is initial cost of time and money. Many people look at the hill they need to climb and decide it’s too much trouble to start. If you can motivate to start however, the hill always looks much smaller once you’re on it.

Which hills are worth it?

Not all hills are worth climbing and an intelligent person knows when to begin the trek and when to pay someone to do it for them. That’s what this article is about: one-time costs are generally worth paying someone else, recurring costs, if possible, should be eliminated.

First there’s one-time costs:

If you are a dentist with no desire to become an architect you wouldn’t go to architecture school in order to design your new practice, you would hire an architect to design it, hire a construction team to build it and be done with it. If architecture was something you were really interested in then you would probably put in the effort to design it yourself.

Either way, this is a one-time cost without any recurring costs. You would pay the architect (or do it yourself) and be done with it forever. You don’t have to pay the architect a monthly fee to occupy the building he designed.

Then there’s recurring costs:

Your internet bill is a recurring cost. You have to pay a monthly fee to keep your internet running and there’s no two-ways about it. You can’t do it yourself in this case because there would be no feasible way for you to create the infrastructure necessary to access the internet. You pay them every month and you get service every month.

There are also recurring costs which don’t have to exist. Your website is an example. You might be paying a large monthly fee for something that actually should be a one-time cost. The person who designed your site only designed it once. There is a monthly hosting fee for anyone who has a website, but it is less than $5 a month. You could significantly reduce a recurring cost if you know what you’re doing.

It’s hard to get excited about a 1% reduction in costs, or a 1% increase in profits for that matter. The excitement of a big move is why the lottery is newsworthy and an audit is not.

What are the odds of a lottery-size increase in profit or decrease in cost happening to your office? I was speaking with a man the other day who was retelling his tales of fortune and his biggest move was buying property in Atlantic City before gambling was legalized. Is this a huge, exciting move? Yes. Was it anything but dumb luck (insider information) and blind risk-taking? No. Is it reproducible? No, it was a once-in-a-lifetime opportunity.

When I was working at Sealed Air I had a colleague in equipment servicing who would go out on calls to fix machinery. The servicemen were additionally allowed to sell products like Bubble Wrap to the customer if they were running low and collect a commission. This man was initially discouraged by the commission brought in by such small sales. By the time he got to those companies they were already a customer with a big equipment investment (with a big commission which went to some other salesperson) and all they needed were small supplies. To paraphrase his words: “All I would make is around $50 per sale which seemed like nothing compared to the commission on the equipment. I barely tried to sell additional supplies and all of the commission from the supply sales went to the salesperson who was called up to resupply. I started to put some effort in and I realized that even though each sale is really small, they’re pretty much guaranteed without much work and each little commission of $50 starts to add up over a whole year.” For him the commission ended up adding about $10,000 per year to his base salary.

How can you use this information?

Think about what you can do to increase efficiency (decrease cost) and generate additional income (increase profit). Let’s say you can decrease your crown prep time or impression time by using a faster setting material. After the initial learning curve maybe this saves you about one minute per patient. Not a lot of time, but what if you do 100 per year? That’s 100 minutes saved. Still boring. But what if you changed 10 things to save one minute per patient for crowns? That’s 1,000 minutes saved. What if 5 of those things you changed translate to other procedures as well? If they save 30 seconds for every patient in your practice, that would be how many minutes saved per year? You could see more patients to increase income or work fewer days and maintain the same salary.

What about selling electric toothbrushes at your office? Will you sell a lot of them? No. But what if you sold 30 per year at a profit of about $30 each? That’s $900 per year which is boring. What if you found 10 more products? That’s $9000 per year!

Assuming you have a website and someone who handles your SEO, what else can you do to increase your web presence? There’s a great tool called a “microsite” that you can start using right away. It’s easy to implement and costs around a quarter ($0.25) per month.

“Microsites” can be a confusing topic so I’m going to try to explain it in human terms: say you just moved to a new city and you were trying to get a feel for what’s out there; restaurants, movie theaters, etc. You decide to take an inventory. How? By driving around and looking at the signs in front of buildings.

You drive by a building called “Glen’s Pharmacy” and it’s obvious that it’s a pharmacy. You drive by a building with a sign that says “Charlene’s Notions” and you don’t know what notions are so you forget about it. Finally you see a store called “Rongeur Depot” (I know, weird city.) You think to yourself, “Oh, I bet I can get dental supplies there if I need to.” Most people who drive by Rongeur Depot think “what the heck is that place?” and they forget about it.

One day you rip a shirt and you need a sewing needle but you have no idea where to go. You drive around town looking for a place that sells “sewing needles.” Since you’re not a sewing enthusiast, you have no idea that notions means sewing supplies. You drive around for 45 minutes until you come across a place called “Rhonda’s Fabrics and Sewing Needles.” Perfect!

You could have easily gone to Charlene’s Notions since you already knew where it was, but you were looking for sewing needles, not “notions.”

In the meantime you made a new friend who decides to go around the city and write down the name of every business for you. He’s not very smart, but he also tries to write a little description of the business based only on the sign. Your friend’s name is Google. He drives around town and finds a hundred places with the word “dentist” in the sign. You call him up and say “I need a dentist, where can I go?” He sends you a list of a hundred people.

You then tell him “I’m actually just looking to get dental implants, where can I go for that?” He looks at his list and sees “Dr. Bob’s Dental Implants.” He assumes that they’re the best place to send you because their sign is the most like what you asked for. Other listings said things like: “Doctor Joe’s Dentistry – fillings, root canals, braces, dentures, implants” but he’s not smart enough to break that down. He sends you them on the list too, but they’re much lower because he thinks the place with only dental implants on the sign must be the most relevant.

Dr. Bob happens to have 35 offices in town, each one with a different sign with only one procedure on it like “Dr. Bob’s Root Canals, Dr. Bob’s Dentures,” etc. Your friend puts him on the top of the list whenever someone asks for a specific dental procedure. How many people ask him just for a dentist? Plenty, but the people who ask him for specific procedures are usually doing some research, are looking for second opinions or are shopping for a dentist. They already know what they want and they’re looking for someone who can do it, just like you were when you were looking for sewing needles and not notions.

In real life, opening up a new office dedicated to only one procedure isn’t all that practical. On the internet it’s simple and almost free. If you have a hosting package for your site, each additional site you want to host only costs $0.99-$7.99 per year.

To put into human terms again: Once you have a main office (or hosting package), all you have to do is pay for a new sign and a cardboard box and you have a completely separate office (or microsite).

How much does the main office (hosting package) cost? Less than $5 per month.

Every new cardboard box office (microsite) takes about an hour to set up and costs about $0.25 per month. That amounts to a lot of exposure for not a lot of money. Each microsite is built to attract a different person who is shopping for a specific procedure.

There are companies who will build microsites for you for around $20-50 per month. If you had 10 of those then it would be around $200-500 per month which is cost-prohibitive. I’ve taught a lot of people how to build microsites so I put together a step-by-step video tutorial on how to do it. If you do it with the help of the video tutorial you can have 100 sites up and running for about $25 per month.

A lot of time at the school is wasted in searching for Perio residents who are not always in the same place, differ from day-to-day and wear the same clinic gowns as the students and faculty. Students waste an average of 15-20 minutes per patient searching for residents for consults and case starts, etc. An easy solution for this is to have residents wear unique, consistent gowns so that they can be easily distinguished from all of the other people in clinic.

How does this translate to practice efficiency?

15-20 minutes per patient looking for something is unreasonable and would not be expected in a private office. However, even a minute per patient adds up to a lot of time wasted per patient, per week. There are plenty of objects in a dental office that are not always in the same place and are difficult to distinguish at a glance. Having consistency with room setups leads to less time wasted. Have a curing light in each room, an intraoral camera in each room, an extra battery pack for a light in each room, etc. means that no time is wasted running around looking for things.

Leader Brand has donated over $1,000 to student chapters of the Alpha Omega International Dental Fraternity and $250 to the Alpha Omega Foundation, a non-profit group that maintains the only two dental schools in Israel.

Check out this article on the LeaderBoard Disinfectable Keyboard published in Dental Connections this month!

Computers are a Recognized Infection Control Problem for Dentists

Traditional keyboards and mice are not designed to address the challenges of use in a dental operatory, presenting infection control problems and actually costing money when used on an ongoing basis.

An ABC News report found that there are 5 times more bacterial colonies on the average office keyboard than on a toilet seat and more can be expected on a keyboard in a dental operatory.

Current solutions include using barrier tape, a minor improvement at the cost of inhibiting the use of the keyboard. Anyone who has used this method knows that it is not ideal. Other solutions include having an assistant with clean hands use the keyboard, a method requiring an hourly wage. These methods cost time and money and don’t work.

What can we do about it?

The LeaderBoard keyboard was designed to efficiently address these issues. The LeaderBoard is a membrane-style keyboard completely sealed in silicone, making it grade IP6 waterproof. This means that you can wipe it down quickly between patients with a standard wipe as if it were the countertop. It has a built-in mouse that is usable with gloves, unlike a touchpad. The LeaderBoard takes up 1/3 the footprint of a standard keyboard and mouse, saving countertop space, and can be used in an assistant’s lap at chairside. The LeaderBoard saves time when setting up and breaking down a room, increasing efficiency. See what the leaders in dentistry have already discovered: http://www.leaderbrand.net/leaderboard.